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Mental Health Providers Support Obama's Gun Control Efforts

Stay ahead of developments in federal and state health care
law, regulation and transactions with timely, expert news and analysis.

By Alex Ruoff

Jan. 5 — Advocates for
behavioral health providers applauded the Obama administration's
new push to support mental health services and bolster the federal
background check system for gun purchases, but some cautioned it
will do little to stem violence.

Renee Binder, president of the American Psychiatric
Association, said in a statement the changes would help curb gun
violence. She said the APA would work with Congress to ensure that
President Barack Obama's proposed $500 million increase in funding
for mental health services would become a reality.

“Gun violence is a public health problem and needs
to be addressed as such,” Binder said.

However, the head of Mental Health America, a
consumer advocacy organization, told Bloomberg BNA that an effort
to encourage more reporting of mental health data to the federal
government's background check system for gun purchases may result
in only a slight uptick in reporting.

Conservatives in Congress and right-wing policy
analysts said the changes would do little to curb violence.
Lawmakers vowed to fight the changes.

President Obama announced Jan. 5 a push to require
all sellers of firearms to perform background checks on their
customers and directed the Social Security Administration to begin
the rulemaking process to include information in the background
check system about beneficiaries who are prohibited from possessing
a firearm for mental health reasons.

Obama also proposed $500 million in new federal
funding for mental health services.

As part of that effort, the HHS Office for Civil
Rights released a final rule Jan. 4 clarifying that certain
health-care organizations and state agencies can report to the
National Instant Criminal Background Check System (NICS) the
identities of individuals who are subject to a federal “mental
health prohibitor” that prevents them from possessing a firearm (02
HCDR, 1/5/16).

Changes in Reporting

The new policy doesn't require physicians directly
involved in patient care to report to the NICS, but would allow
certain state health agencies with the authority to make
adjudication or commitment decisions regarding mental health
patients to report to the background check system without fear of
violating the Health Insurance Portability and Accountability
Act.

Local courts typically make the determination
whether someone is capable of standing trial or not guilty of a
crime by reason of insanity, which also deem an individual
ineligible under federal law to purchase a firearm.

The OCR's final rule likely will affect only a few
small psychiatric hospitals and public agencies, Paul Gionfriddo,
president and chief executive officer for Mental Health America,
told Bloomberg BNA Jan. 5. Most agencies that report to the NICS,
such as court systems, aren't covered by HIPAA because they don't
offer health-care services, he said.

The policy change was purposefully narrowly tailored
to ensure that those voluntarily seeking mental health services
wouldn't be reported to federal authorities, he said.

“The worry was that someone might end up on a list
because they went to see a psychiatrist,” Gionfriddo said. “That
wasn't really ever being considered but they clearly wanted to
avoid making this too broad.”

With the change, the NICS system could see as much
as 1,000 new records, he said.

Providers of mental health services don't want to
report data about their patients to federal authorities for fear of
discouraging someone from seeking treatment, Mark Covall, president
and chief executive officer of the National Association of
Psychiatric Health Systems, told Bloomberg BNA.

Lawmakers' Response

“More money into our disastrously failed and
antiquated system will only result in more lives lost,” Rep. Tim
Murphy (R-Pa.), who has long pushed for reforms to mental health
care, said in a statement.

Murphy introduced a bill (H.R. 2646) in 2015 that would alter HIPAA to give caregivers and families more access to patients' health information .

House Speaker Paul Ryan (R-Wis.), in a Jan. 5
statement, warned that the president's executive actions would be
overturned if a Republican wins the presidential election in
November.

The National Center for Policy Analysis, a
conservative policy think tank, said in a statement that the
changes Obama proposed “would do nothing to prevent gun violence”
and would discourage some from seeking mental health
services.

Records for NICS

Obama, speaking at a press conference in Washington,
said he'll immediately hire more Federal Bureau of Investigation
employees to process background check applications and bolster the
NICS.

He also touted the Department of Health and Human
Service OCR change as a way to ensure that more mental health
records will be submitted to the NICS.

However, state health agencies and mental health
facilities have long complained that technology failures and
privacy concerns have prevented them from reporting to the NICS,
according to the OCR's final rule.

HIPAA doesn't require state agencies to report to
the NICS the identities of individuals who are prohibited from
purchasing firearms under either federal or state laws, the rule
said. Additionally, HIPAA-covered entities may only use and
disclose mental health data with an individual's express written
authorization.

The NICS records are submitted voluntarily by local
and state agencies as well as mental health institutions,
psychiatrists, police departments and family members requesting
placement of individuals into the system, Holly Henry, an FBI
spokeswoman, told Bloomberg BNA in an e-mail.

The number of mental health records in the NICS grew by more than 2 million between 2011 and 2015, according to FBI data.

There are currently more than 4.25 million mental
health records in the NICS, up from 1.8 million in 2011, according
to the FBI.

The NICS can have multiple records for each person
reported to the system, Henry said, meaning there are fewer than
4.25 million individuals banned from purchasing a firearm due to
mental health reasons.

Mental health prohibitions are the
eighth-most-common reason people have been denied by the NICS,
according to the FBI. More than 21,000 background checks were
denied under the “adjudicated mental health” category between
November 1998 and December 2015.

To contact the reporter on this story: Alex Ruoff in
Washington at aruoff@bna.com

To contact the editor responsible for this story:
Patty Logan at plogan@bna.com

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